What Do I Do If My Claim Is Denied
The majority of applications are denied, but dont let a claim denial deter you. If you feel you cannot work because of your medical conditions, appeal the denial within 60 days.
Appealing an initial denial moves your claim to the second stage, which is called Reconsideration. Social Security assigns your claim to another disability examiner to reconsider the evidence. Social security may send you reports to complete, or schedule an evaluation with a doctor. It is important to your case that you comply.
The bad news is that most claims that reach the Reconsideration level are denied.
The good news is that if you appeal within 60 days you move to the third level, the Hearing, which is when the majority of applications are approved.
Diagnostic And Statistical Manual Of Mental Health Disorders
The DSM is the Diagnostic and Statistical Manual of Mental Health disorders and its used by clinicians to diagnose and treat mental disorders so basically most policies say if you have a condition that pops up in the hundreds of pages of the DSM that is a mental health condition. One trend they have noticed is the exclusion of conditions and theyre going to read it to you from the UNUM because this one seems to be the most consistent, a mental disorder means any disorder except dementia resulting from a stroke, trauma, infections or degenerative disease such as Alzheimer. So basically what its doing is its excluding any condition that is caused by a structural, a structural process such as dementia that results from Alzheimers or a stroke which can cause cognitive issues.
So, what does that mean to you? Well first, its a wake-up call that your disability policy may cut off after 24 months, second that means we need to do an investigation together. The first thing theyre going to do when you contact a Disability Attorney is theyre going to check the policy to see which one of these limitations applies to you and the second thing theyre going to do and this is what they often do in cases, is they are going to find out is that why youre disabled maybe it is, and well work with that if thats the case but maybe thats a secondary condition.
Getting Disability Benefits For Mental Health Issues
The Social Security Administration acknowledges the impact that anxiety and depression disorders can have on a persons ability to make a living and get by in society. Both of these families of conditions are considered qualifying medical disorders for establishing eligibility for disability payments.
The process of applying for disability with anxiety or depression is the same as it is for physical disabilities. In order to get benefits, you must submit an application with the Social Security office in your local area. Be prepared to submit documentation of your condition from a doctor or psychiatrist who has treated you. Ask relatives, friends and people who know you whether they can write brief statements about how your mental health and ability to function have been affected by the anxiety or depression. These statements are not definitive, but they can help paint a whole picture for the disability eligibility reviewers.
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Can You Go On Disability For Depression
It is possible to go on disability for depression, but an individual with this disorder must meet certain criteria to be eligible to receive benefits. The specific criteria are listed in Social Securityâs listing manual. In some cases, applicants may be granted disability on the basis of a medical-vocational allowance if the depressive symptoms are severe and other factors are present in the applicantâs work history, age, and level of education.
Depression is listed as Social Securityâs impairment listing 12.04, Depressive, Bipolar, and Related. To qualify for Social Security disability benefits for depression, you must demonstrate that you have a severe form of the disease by manifesting at least five of the following symptoms:
â Depressed mood
â Diminished interest in all or almost all activities
â Poor appetite or overeating that results in a demonstrable change in weight
â Sleep disturbances
â Inability to concentrate or think clearly
â Feelings of guilt or worthlessness
â Thoughts of suicide or death
â Slow physical movement or reaction time
â Slowed speech and physical agitation such as hand wringing or pacing
Additionally, you must meet certain functional criteria that show that your ability to work has been impaired as a result of the depressive disorder. An extreme or âmarkedâ limitation in two of the following areas is necessary to receive disability benefits for depression:
Depression Disability Benefit Programs
Finding yourself in this situation may seem hopeless, but it isnt. There is the hope of solving the problem. The SSDI is a certified program created to support individuals going through the tough phase. The program doesnt cater to every person battling depression, not unless you fit the criterion used.
When you qualify to receive some benefits if your depression leads to disability, you and your family members receive benefits once you enroll in the program. Supplemental Security Income covers adults and children with less financial capabilities and resources.
Even though the two programs work separately, their main aim is to assist individuals with disabilities, and depression disability is included. If you plan to apply to the program, do your research and know what is required during application to smoothen the process.
The medical requirements for both programs are the same. For the non-medical criterion, you are entitled to monthly benefits if your medical condition lasts a year or longer and if the illness may lead to death.
The requirements for enrollment in disability programs include:
- Inability to work due to depression.
- Assets are lower than $2000 worth.
- Spouses also have insufficient support, and combining you and your spouses assets should be lower than $3000 in total.
- Your depression should be considered severe to be a disability.
- You cannot work based on your current condition, age, disability, and work history.
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How Is Depression Diagnosed
Before filing for long term disability, the first step is receiving a diagnosis for your depression. The insurance company will require proof of diagnosis to approve your claim.
A doctor will be able to give you a correct diagnosis. First, a doctor may conduct a physical examination, blood labs, or other testing to rule out other health conditions causing your symptoms.
If your symptoms are not caused by other illnesses, your doctor may conduct a mental health evaluation. Your doctor may also provide a referral to a trained mental health professional, such as a psychiatrist, who is experienced in diagnosing and treating depressive disorders.
Your doctor or mental health professional will likely conduct a full diagnostic evaluation. By interviewing you on your moods and behaviors, and how long these symptoms have persisted, your doctor will determine whether you are suffering from clinical depression.
In addition, your doctor or mental health professional may question you on any family history of depression or other mental illnesses. Your doctor or mental health professional may also talk to your close relatives or spouse to see how they describe your symptoms and family medical history.
Identifying Individuals At High Risk For Permanent Disability From Depression And Anxiety
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
Mental illnesses, among which depression and anxiety are most common, are the leading cause for permanent disability. It is of interest to know what case characteristics determine if a person returns to the work force in spite of mental illness to tailor specific interventions. So far, there has been little research into this field. In the present study a sample of 202 workers who had permanent disability due to depression/anxiety were followed-up on. 22% started some kind of work during follow-up in a period of 30 to 75 months. Logistic regression analyses showed that quick progression into disability, short period of disability, younger age, adequacy of income replacement through insurance benefits and no previous disability predicted return to work. These findings also allow to identify individuals at high risk for progression into permanent disability that can benefit from supporting interventions.
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Other Ways To Qualify For Disability For Depression
Meeting the requirements of the clinical depression listing, above, isn’t the only way to receive an approval for disability . If Social Security finds that your depression isn’t severe enough to meet the listing above, the agency will determine if you can be approved for benefits by being granted a “medical-vocational allowance.” Social Security will consider how your depression symptoms affect your ability to do any type of unskilled work, by looking at your ability to:
- carry out simple instructions
- respond appropriately to supervision and to co-workers, and
- handle changes in routine.
Social Security will then give you a rating of the type of work it thinks you can do .
If depression is the only impairment you listed on the disability application, getting disability will be a long shot unless you have severe, disabling depression and can qualify under the listing for depression. But if you also have a physical impairment or another mental impairment along with depression, you have a better chance of getting benefits.
Depression Disability Benefits: The Ultimate Guide
I wrote The Ultimate Guide to Depression Disability Benefits for people who need to win or maintain disability benefits for Depression.
This Guide is based on my 25 years experience as a former occupational therapist and now disability lawyer. This Guide is meant to give you an overview of the types of benefits you may qualify for and the challenges you will face.
Because you are reading this Guide, I know you are on the right path. Educating yourself is the single most important thing you can do to improve your chances of success with any disability claim.
If you have questions about this Guide, or any disability claim issue, call our support team toll free at .
Keep on learning and I wish you all the best with your journey,
David Brannen, disability lawyer & founder, Resolute Legal
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Anxiety Disability Claim Depression Disability Claim We Are Here To Help
The long-term disability claim process is complex and can be very difficult to navigate on your own, especially when your life is already disrupted by the effects of anxiety or depression. If you are considering making an anxiety disability claim or a depression disability claim, have already started the claims process, or your long-term disability claim application has been denied, Ludwar Law Firm can help you. With over 25 years of experience handling long-term disability claims for depression and anxiety, Ludwar Law Firm stands out above the rest. Clients of our Calgary-based law firm from all over Alberta and Saskatchewan appreciate being able to talk to people who can explain the process, their options, and what will happen during their claim. Contact us today to schedule your free consultation.
Ludwar Law Firm
How To Apply For Disability Based On Depression
If you’re applying for Social Security disability insurance , you can file your whole claim online on Social Security’s website. Applying online is generally the fastest way to apply for benefits, but you can fill out the application at your own speed. Most individuals filing for SSI only can’t file the entire application online, but they can get started on Social Security’s website. If you’re not comfortable online, you can call Social Security at 800-772-1213 to start your claim. For more information, see our article on applying for Social Security disability benefits.
If you’d like help with your application, or you just can’t get started, think about working with an SSDI expert. According to a survey of our readers, applicants who filed an initial application without expert help were denied 80% of the time. Click for a free case evaluation with a legal professional to determine whether your depression is severe enough to qualify for benefits.
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How Much Does Disability Pay In Ny
For an individual, the federal monthly benefit amount is $771. For a couple, the benefit amount is $1,157 per month. The actual amount that a beneficiary receives, however, depends on the income they received prior to leaving their job and the amount of taxes they paid during the time they were working.
Beneficiaries canât collect disability benefits at the same time that they receive paid family leave benefits. A beneficiary may only collect benefits for 26 or fewer weeks from either disability leave or paid family leave during any 52 week time period.
While on disability in New York, beneficiaries are responsible for their medical care expenses. Neither the employer nor their insurance carrier is responsible for any medical expenses the beneficiary incurs.
Prior to receiving disability, the beneficiaryâs employer is allowed to take a contribution from employees to offset their disability insurance benefits costs, but this isnât required. The contribution that an employer can take is 0.5 percent of the employees wages, but no more than 60 cents per week. Employees with two jobs that yield more than $120 per week can ask for an adjustment in the contribution from two employers such that the combined contributions donât exceed 60 cents weekly.
Medical Evidence Required For Disability Based On Depression
Your treating doctor should be able to submit a comprehensive psychiatric report and a well-documented psychiatric medical record showing the history of your depression to the SSA. Your psychiatric record should include all treatments attempted, including the types of medication and therapy, and the efficacy and side effects of each treatment. Your doctor should also include detailed examples of how your depression affects your daily activities and your ability to hold a job.
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Residual Functional Capacity For Depression
If you cannot show that you meet the listing for depression, you may still qualify for benefits if the Administrative Judge finds that your residual functional capacity prevents you from working. To determine your residual functional capacity, the Administrative Law Judge will look at all of your impairmentsmental and physicaland determine what sort of work you may be able to do.
Oftentimes, people suffering from depression also have physical problems, such as chronic pain, or other chronic illnesses also make it difficult to do physical work. With depression, a persons ability to concentrate and stay on task during the workday is often affected.
Moreover, people suffering from serious depression are likely to miss work due to lack of motivation or medical appointments. If the Administrative Law Judge finds that youre going to be having unexcused absences or be off task while at work due to mental illness, they may find you disabled for these reasons as well.
Please be aware that it is very difficult to win Social Security Disability benefits for depression unless youre treating providers are very supportive and write specific statements on your behalf supporting your disability claim. Having a supportive treating family physician, psychiatrist, or psychologist is very important for these types of claims.
The following are some of the clinics in West Michigan we find to be most helpful in supporting Social Security Disability Claims for mental illness:
Can You Get Disability For Depression
Depression is considered a disability. The Social Security Administration has a listing for depression, and if you can meet those criteria by providing extensive medical evidence and other supporting documentation, your claim will be approved.
You will need to provide exam notes, any mental testing records, reports from your therapist or counselor, and notes from any psychiatrist or psychologist who has treated your condition. The more evidence and documentation that you can provide, the more likely you are to have a successful claim.
A residual functional capacity form completed by your physician can be essential to the success of your disability claim. It will detail what you can and cannot do physically and mentally. When it involves depression, it will detail your ability to focus, if you have difficulty concentrating, your memory skills, your social skills, and your overall mental state.
It will help the disability examiner get a full picture of what you can and cannot do. The RFC can help the disability examiner determine if you meet the criteria of disabled and qualify for disability benefits.
You will need to provide medical records detailing your treatment and whether it has helped. As an example, any prescription drugs you have taken, if you have undergone therapy, and whether the treatment has helped in any way.
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Provide Evidence From Your Doctor
When determining whether your depression is disabling, your insurance company will likely also want the opinions of your treating doctor. Your doctors support is key. Your doctors reports should focus on:
- The frequency and severity of your symptoms
- Any positive mental status exam findings
- Their direct observations of you during office visits and
- The specific restrictions and limitations that prevent you from working.
Warning: Ltd Policies And Mental Illness Limitations
One thing to keep in mind when filing for long term disability is whether your long term disability insurance policy includes a Mental Illness Limitation.
Policies that contain a Mental Illness Limitation typically limit your benefits to two years if you are disabled due to a psychiatric condition such as depression or anxiety. Of course, each policy is different, so the prescribed maximum period may be shorter or longer depending on the terms of your particular policy.
Some policies with Mental Illness Limitations contain exemptions for certain mental conditions occasionally, bipolar disorder is exempt, though most other depressive disorders are not.
If you are solely disabled due to depression and your policy contains a Mental Illness Limitation that does not exempt it, your benefits will most likely stop when the maximum allowable period expires. Unfortunately, the severity of your mental illness will become irrelevant after the maximum allowable period expires.
However, if you can demonstrate that you are disabled due to objective cognitive problems, your benefits may extend beyond limitation period. A neuropsychological evaluation, as discussed earlier, can provide this evidence.
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